Emma Cumming and Andrew Wallace

We had the amazing opportunity to join Dr Adrian Sheen and his wife Suzy on a visit to Fiji for two weeks in July 2015. It was a very diverse time with visits to multiple local health centres along the Coral Coast as well as the sub-divisional hospital in Sigatoka.

The trip was a great introduction to primary health care and we observed it at multiple levels within the Fijian health care system.

Dr Sheen emphasised the importance of understanding the full context in which people access primary health care and so we also visited the local pharmacies and diagnostic labs. This was an important experience to became more aware of the differences in the Fijian health care system where both diagnosis and treatment are dependent on the availability and accessibility of resources.

While we observed many skin and respiratory infections, there were also the more challenging presentations of chest pain and fevers, potentially Dengue. When needed, transfers to the larger divisional hospital in Lautoka had to take into account both the need for further care and the accessibility for the patient and their family.

The local Fijian doctors were extremely welcoming and keen to teach us, from the sub-divisional medical officer Dr Dasi down to the new interns. Dr Sheen has a strong relationship with Dr Dasi based on his involvement establishing a new health centre in the village of Vatukarasa. We greatly benefited from Dr Dasi’s experience and generosity with her time.

None of this would have been possible however without Dr Sheen and Suzy’s hard work and commitment to the Coral Coast both at the Vatukarasa Health Centre and other local villages.

We were not only taught valuable clinical medicine but the necessity and great benefit of an excellent rapport with the community when promoting health. To assist and make a difference when coming from overseas, it became clear that to develop a long term relationship with an area the most essential ingredient is continuity.

We were lucky enough to be invited into homes and villages, attending (and even competing!) in choir competitions, sharing food and traditional Fijian kava and playing with the children.

By conducting health screening clinics in conjunction with the community healthcare teams, we saw over 200 patients and attempted to give back to the local community.

Both of us hope to be able to return to the area in the future and help continue the important work and relationship with the community.